Qualitative investigations were conducted with three discrete health groups, involving asthma sufferers,smokers considering quitting, and personal carers of people with multiple sclerosis (MS). The participants searched for and commented on the different kinds of health information that was available online, including discussions and postings about shared patient experiences. Different patient groups clearly showed different communication needs in terms of their online search behavior and this reflected (i) the information available on and offline, (ii) the success of previous patient-clinician communications and also (iii) the complex coping strategies of the patients and carers themselves. We captured these needs in a new engagement framework that can be used to guide the design of new online systems and to support developments in patient-clinician communication.